{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T09:51:36Z","timestamp":1769680296469,"version":"3.49.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Large adrenal tumors (LATs) pose challenges in clinical management, with varied approaches and outcomes reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>To analyze the surgical outcomes of large adrenal tumors and compare the minimally invasive and open approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and design:<\/jats:title>\n                    <jats:p>Retrospective analysis of large adrenal tumors operated at a tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and material:<\/jats:title>\n                    <jats:p>Tumors\u2009\u2a7e6\u2009cm on preoperative imaging were included. Data encompassing demographics, preoperative evaluations, surgical techniques, perioperative outcomes, and histopathological findings were analyzed. Receiver Operating Characteristic (ROC) analysis was used to determine a tumor size threshold predictive of malignancy. Statistical analysis was performed using SPSS v26.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean age was 46.9\u2009years, with a female predominance (70%). Incidental findings accounted for 52.2% of cases, while pain was the most common presenting symptom. Functioning tumors comprised 52.17% of cases, with no significant association between functioning status and malignancy risk. ROC analysis identified 7.4\u2009cm as a malignancy-predictive cutoff (AUC\u2009=\u20090.77,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.027). Laparoscopic and open approaches demonstrated comparable outcomes, with laparoscopy associated with lesser blood loss (90 vs 232\u2009ml,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001) and significantly fewer major complications (0% vs 17.3%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our study underscores the importance of vigilant evaluation and multidisciplinary management in LATs. Tumor size emerged as a critical determinant of malignancy, with laparoscopic surgery offering safe and comparable outcomes to open surgery in selected cases. Prospective studies are needed to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03915603251381390","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T09:43:57Z","timestamp":1760435037000},"page":"60-66","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating Large Adrenal Tumors: Insights from Minimally Invasive Surgery at a Tertiary Referral Center"],"prefix":"10.1177","volume":"93","author":[{"given":"Karthik","family":"Venkataramani","sequence":"first","affiliation":[{"name":"Department of Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalini Shree","family":"Krishnamurthy","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathiresan","family":"Narayanaswamy","sequence":"additional","affiliation":[{"name":"Apollo Cancer Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2585-8527","authenticated-orcid":false,"given":"Anand","family":"Raja","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/658483"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.11135"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08380-7"},{"issue":"1","key":"e_1_3_3_5_2","article-title":"Association between tumor size and malignancy risk in hormonally inactive adrenal incidentalomas","volume":"12","author":"Vural V","year":"2020","unstructured":"Vural V, K\u0131l\u0131n\u00e7 EM, Sar\u0131demir D, et al. Association between tumor size and malignancy risk in hormonally inactive adrenal incidentalomas. Cureus 2020; 12(1): e9628.","journal-title":"Cureus"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9508-1"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-2420"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvad066"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.4293\/108680810X12924466007160"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.4103\/jmas.JMAS_266_19"},{"issue":"12","key":"e_1_3_3_11_2","article-title":"Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults","volume":"12","author":"Arezzo A","year":"2018","unstructured":"Arezzo A, Bullano A, Cochetti G, et al. Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults. 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